Despite decades of progress in improving the delivery and availability of family planning services, high levels of unmet need for family planning still exist in many countries. This suggests that novel approaches are needed to extend access to family planning services to women and couples who desire to limit or space their childbearing but are not currently using contraceptives. The integration of family planning with other health services may be one such approach. Although integration may seem logical, the results of efforts to integrate child or primary health care services with other services suggest that integration presents many logistic challenges and that caution is advisable.

What challenges does your project address and why is it of importance?

Despite decades of progress in improving the delivery and availability of family planning services, high levels of unmet need for family planning still exist in many countries. This suggests that novel approaches are needed to extend access to family planning services to women and couples who desire to limit or space their childbearing but are not currently using contraceptives. The integration of family planning with other health services may be one such approach. Although integration may seem logical, the results of efforts to integrate child or primary health care services with other services suggest that integration presents many logistic challenges and that caution is advisable. Integrating family planning services with other health services may be an effective way to reduce unmet need. However, greater understanding of the evidence regarding integration is needed. The study determined the effectiveness of provider initiated approaches to enhance family planning uptake among women of reproductive age in rural communities in Osun State, Nigeria.

How have you addressed these challenges? Do you see a solution?

A total of 10 out of 30 Medical Officer of Health (MOH) in Local Government Areas in Osun State were randomly selected and trained on Provider Initiated Approach to scale up the uptake of FP among women of reproductive age in rural communities in Osun State, Nigeria. The selected MOH were equipped with FP knowledge and skills on how to integrate FP with other health services. The trainees in turn trained lower health workers who are the primary service providers in rural areas in their various local government health facilities. Women within the reproductive age are assessed for FP needs in antenatal care, maternal and child health, Post Natal Clinic, HIV counseling and testing and other reproductive health services. Family Planning messages were discussed with women through micro-teaching, IEC Materials and as well as client provider interaction. This was done from March to August, 2012.

How do you know whether you have made a difference?

Utilization of FP services increased from 5.8% to 30.2% within 3 months and 42.9% after 6 months. The prevalent use of Intrauterine device, injectable, implant and emergency contraceptives increased from 12.8%, 10.1%, 0.2% and 4.7% respectively to 30.8%, 29.7%, 3.9% and 12.9% respectively. Identified barriers to use of FP among women included inadequate knowledge of FP, negative perceptions of FP, financial constraints and inadequate spousal approval. Excess workload for health workers was recorded as a major challenge in this approach.

Have you or the project mobilized others and if so, who, why and how?

There was an increased in uptake of family planning services due to use of provider initiative family planning. More health care providers should be trained towards using this approach since current evidence suggests that integration of family planning with other health services using provider initiative approach may be beneficial.

When your donor funding runs out how will your idea continue to live?

The government, through the Ministry of Health, will take over the project